Organization
SAMS EAST INC
Active
Other names
Sams Pharmacy 10-6506
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
1201 N WESTOVER BLVD, ALBANY, GA 31707-6600
(229) 888-3400
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009747
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003129130A
—
GA
01
—
2129003
PK
—
Enumeration date
02/23/2011
Last updated
06/17/2025
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